Tied Together With A Smile
by Alycat13
Summary: An Amelia centric story with some Shepherd Sisters and Addek. Amelia has had problems with drugs for a while now, but no one wanted to believe she was so close to rock bottom. A pivotal moment for Derek and Amelia as she is on the brink of death. Set during Derek, Mark and Addison's intern year. Based on the song by Taylor Swift
1. Hold on, baby you're losing it

**Dedicated to my mom who passed away ten years ago this Tuesday to a drug overdose.**

 **This story is focused on Amelia with some Addek thrown in, enjoy.**

" **Hold on baby you're losing it.**

 **The water's high you're jumping into it now**

 **and letting go**

 **and no one knows"**

 **Tied Together With A Smile- Taylor Swift**

Lizzie stood at the counter in the kitchen of the Shepherd house, pouring creamer into her coffee. From where she was standing she could see into her parent's room, the big king sized bed where her and her siblings used to crawl into to watch movies with their parents.

She was watching her youngest sister, Amelia who didn't know she was being watched.

Lizzie had came over to drive with her mother to see her sister in New Jersey. Nancy just had another baby, a little girl, and they were going over to help. Carolyn came into the kitchen, dropping a box on the counter of presents for Nancy's children. She opened her mouth to ask what Lizzie was looking at but her daughter held a finger to her lips and pointed toward her youngest child.

Amy was coming down from her high fast. She wasn't sure how she ended up at her childhood home but she was too high to care. She had slipped in through a partially broken screen on the back porch and entered the house through the sliding glass door her mother always had open to let the crisp New York air in.

Amelia licked her lips, running her hand through her knotted hair. Her bank account was below zero. She owed money to more people than she could remember.

Her mother always had a big collection of jewelry she never wore, and the twenty year old figured she wouldn't miss it. She filled the pockets of her ripped jeans with a few necklaces and earrings before spotting her father's watch at the bottom of the drawer. The watch held so many bad memories of her father being killed that she was surprised her mother even got it from the police station. She stuffed it into her pocket before taking out her last oxy and cutting it with a razor blade. Her nose was down to the dresser when her mother and sister entered.

"What do you think you're doing Amelia?" Carolyn demanded.

Her red rimmed eyes searched the room for an exit, like she was a caged animal. She stumbled back a few steps.

Lizzie pushed the crushed bits of OxyContin onto the carpet covered floor, intent to vacuum it up later so long as her sister couldn't take it now. "Answer the question Amy."

"No one can call me Amy except for my brother." She hissed back, wiping the white powder off her nose.

"Amelia why are you stealing?" Carolyn asked though they all new the answer.

"I- I was just leaving. My boyfriend, you'd like this one mom, he's waiting for me. I just wanted to borrow some jewelry for a date thing." She lied badly, wringing her hands as she excessively licked her lips.

"Is this one a drug dealer too?" Lizzie crossed her arms across her chest.

"Hey Elizabeth I don't judge you and you're cheating husband. Leave me and my business alone." Amelia shot back.

"Lizzie, go pack up the car." Carolyn instructed, trying to placate the fight that was brewing. "Now." They watched her leave before Carolyn turned to address her baby. "Amelia are you okay? Are you safe?"

"I'm fine mom, stop worrying."

Carolyn looked over her daughter who was the opposite of fine. Her hair was greasy and knotted, her eyes bloodshot and lips cracked. She had sweat dripping down even though the house was cold and kept wiping her nose on the back of her arm.

"Mom, I'm fine, seriously." She repeated, fidgeting from the withdraws and weight of her mother's gaze.

She put her hand out and Amelia reluctantly pulled most of the jewelry out of her pockets, leaving a few pieces she hoped to sell once her mother finally let her leave. "You don't have to steal honey."

"I told you I am borrowing it for a date." She coughed into her elbow.

"Come to Nancy's with us, all your sisters will be there and we can spend some time together."

"Nancy doesn't want me there, she made that glaringly honest when she kicked me out last year." Amy could still remember her sister yelling at her for being the family disgrace and banning her from seeing her nieces and nephews. To be honest she didn't want to ever see Nancy again, high or not.

"Nancy was just upset."

"Mom I'll come over when you get back and we can have dinner or something." Amelia offered. "You can even meet Anthony, he's a lost soul like Mark and Addie."

Carolyn pulled her baby close, never wanting to let her go. "I love you so much, you know that?"

"Yeah mom."

Carolyn held her husband's watch in her hand and prayed her youngest would get clean soon. She learned early on that you can't force an addict to get clean, they have to want it for themselves.

"You're letting her go?" Lizzie stood next to her mother as they watched Amy drive off.

"What do you want me to do Elizabeth? I can't force her."

"Call Derek and Addison, or even Mark, and just have someone check on her while we're gone. I haven't seen her this bad mom." Lizzie leaned into her mother's embrace.

"Amelia is strong, just like I raised all of you to be." She tried to assure her but she was worried herself. "But I'll tell Derek to check up on her."

Amelia Shepherd stood outside her dealer's apartment. She had a wad of cash in her pocket, about a grand that she got from selling her mother's jewelry.

"Who's there?" A voice came through the speaker.

"Amelia."

She heard a buzzer and the doors opened. She climbed the three flights of stairs to the apartment of her best friend, her only friend. He pulled her in and kissed her lips. "How's it going beautiful?"

"Vince." She greeted. "I need my usual hit, I got the cash."

"Chill out and take a hit, I'll set you up." He motioned to the bong sitting in front of the couch while he went into the back to grab 25 pills. "You got a place to stay tonight?"

"Yeah my brother's working so I'm gonna crash at his place." Amelia knew where Derek hides his spare key. "Thanks V." She handed him the cash and took the baggie of pills and stuffed it into her bra.

Amelia pulled her jacket tighter around her as she walked in the direction of Derek and Addison's brownstone. She was thankful they lived by Central Park because everything was pretty much around there. She swallowed two pills dry, relishing in the bitter taste that promised better was to come.

She took her time walking toward the brownstone, the cool air biting her nose. She kept her hood up, her phone rang but she didn't bother to look at who was calling. She wasn't in the mood to talk. She crushed up a few more pills in her mouth as Derek and Addison's came into view. The lights were off and she quickly disabled the security alarm before locking up behind her. She went to the guest room at the far end of the house, knowing the newlyweds barely ventured there so she could keep a few things hidden. The small girl wrapped a blanket around her slight frame.

She regretted not taking her mother up on her offer to tag along, but she didn't want her to see her like this. She couldn't stand the pity in the eyes of her mother or sisters. Addison was a better sister than her actual ones, but she sided with Derek and when he pushed her out of his life than Addie went as well.

She can feel the depression creeping back into her mind, her last dose wearing off quicker than she could remember.

The razor blade in her pocket was unwrapped on the counter before her as she crushed up four oxys at once and put them into two short, neat lines. Her nose was against the counter as she breathed in her next high, feeling it almost instantly. She wanted to make sure this high lasted, so two more pills were ingested the same way as before.

Amelia went to sit on the couch after, relaxing into the warm leather that was much more Derek than Addison. Her eyes drifted shut, a soft smile on her lips.


	2. coming undone

" **You cry but you don't tell anyone, that you might not be the golden one**

 **and you're tied together with a smile but you're coming undone."**

Chapter 2:

-Derek-

32 hours into his 36 hour shift, Derek was exhausted. He found Addison in an on call room, retying her shoes that she always took off before lying down.

"How'd your surgery go?" She asked.

"Webber barely ever makes a mistake, the patient is doing great. He got the whole tumor out of her liver with good margins." He yawned, sprawling out behind her and planting a soft kiss on the skin of her hip which was exposed through her scrubs.

"Stop distracting me." She pushed him away, with a playful smile on her lips.

His phone rang and he let out a loud groan. Seems like sleep is not something in the cards today. He flipped the phone open and put it to his ear, his eyes watching his wife. "Dr. Derek Shepherd speaking."

She leaned down and placed a kiss on his cheek. "Meet me in the lobby when you get off."

He nodded.

"Derek! Sweetie how are you? I hope I'm not interrupting anything." His mother's voice rang through his ears.

"No, of course not mom. I was just going to rest for a bit before rounds."

"Well I'll make it quick then. Your little sister came by yesterday before Lizzie and I were leaving for Nancy's. She didn't look well."

"She's a drug addict mom, how did you expect her to look?" Some people didn't have the option to fall apart, everyone else got their life together so he felt Amy should as well.

"Derek Shepherd watch your tone. She tried to steal your father's watch. Just do me a favor and check on her after work and while I'm gone."

"Fine mom, I'll call her or something."

"Tell Addison and Mark I send my love and expect all of you this thanksgiving, no excuses."

"I'll pass along the message, but we're interns so no promises."

"Sorry I didn't hear that last part, must have been going through a tunnel."

"Mom I can hear Nancy's kids in the background, you're at her house." He shook his head at his mother's antics.

"I love you Derek."

"Love you too mom." He hung up the phone and dialed Amy right after. "Hey Amy call me back." He left a message.

Five hours later he met his wife by the coffee cart on the first floor, holding a cappuccino for her and one for himself.

"I love you." Addison took the cup in both hands and brought it to her lips.

"Are you talking to me or the coffee?"

"Both." She shrugged.

He helped her into her coat, pulling the zipper up on his own. "My mom wants us to check on Amy."

"Let's sleep first, I don't think I could deal with the two of you fighting unless I get some sleep."

"I can not drive all the way to Brooklyn like this. Anyways she was at mom's earlier so she's probably not even home yet." They were both avoiding something they didn't want to face yet.

"Did you leave the lights on?" Addison stood on the sidewalk staring up at their home.

"Not that I remember. Did the cleaning lady leave it on?" He unlocked the door, holding it open for Addison.

"She doesn't come until Wednesday."

"Hello?" He called into the house, earning no response. He walked in further barely pausing long enough to tell Addison to call the paramedics.

Amelia was slouched forward on the couch, her body barely breathing. He picked her small body up and laid her flat on the ground, unzipping her jacket so he could feel for her pulse. He could barely find it. He started compressions.

1-2-3-4-breathe

He felt a rib crack under the pressure he was exhorting onto her chest, but couldn't force himself to stop. "Amelia! Wake up Damnit. You can't die. Amelia!" He yelled at her, tears streaming down his face.

"Derek the ambulance is on its way, let me take over." Addison urged.

"No, I've got this. Watch for the paramedics." He disregarded her offer to help.

"If you break her ribs that could puncture her lung Derek."

"I'm a doctor Addison, I know what I'm doing." He yelled back. "Amy, don't you dare do this!"

They watched as she was strapped to a stretcher, her slight body trembling with the force of the compressions the paramedic was performing.

"I'm going with her. Take her to Mt. Sinai." Derek told them.

Addison pushed him toward the ambulance, the siren already running loud and clear. "She'll be okay. I'll call your mom and drive behind you, don't let Mark see her."


	3. With a Smile

" **It doesn't matter how tough we are, Trauma always leaves a scar."**

 **To My Mom, Rest in Peace**

 **A/N: I hope none of you ever have to go through something like this. Just know if you need to talk I'm here.**

 **Chapter 3:**

"20 year old woman, possible drug overdose. Cardiac arrest, lost her twice on the way here. Has not regained consciousness." The paramedic told the doctors waiting in the ambulance bay.

"Trauma bay 3." The attending instructed. "Shepherd what are you doing back already?"

"The patient, _it's_ my baby sister." He stood by the window, his eyes focused on her body that jumped every time they shocked her.

"I need some help in here." A resident called out of the room.

Derek watched as Mark headed toward the call for help, not noticing his best friend whose back was toward the doorway. He froze in the doorway, the head of Raven curls knocking the breathe from his lungs. "Sloan get out of here." Someone yelled, but he didn't move. Derek was of no use to help. "Sloan, clear out."

Addison had a childhood worth of experience suppressing her emotions, something that only really came in handy for the first time today. She handed Derek the phone she came in with, the voice of his mother asking questions he couldn't answer. Addison pulled Mark from the room, unable to look at the girl in the bed herself. "Dr. Carter, please, you have to save her."

"Get them out of here Montgomery. I'll send someone when I have any news." He barked, no time to coddle the interns at the moment.

The three interns waited as close by as they were allowed, Mark's arm over Addison's trembling shoulders. Derek paced back and forth, wishing he could have prevented this.

Kathleen was the first of the Shepherd sisters to arrive, she had been on her way to Jersey when she got the call from her mother and turned right around. "Is there any news?" She went right to them and wrapped her arms around her brother.

"She hasn't coded again but she's still unconscious. They just finished pumping her stomach." Addison whispered, her voice breaking.

"Where did you find her?" Her youngest siblings didn't normally run in the same crowds.

"She broke into our house. I found her in the living room." Derek muttered.

"Mom's still a few hours away, Nancy's husband is watching all the kids and her and Lizzie are on their way." She told them. "Mom's a wreck. She thinks this is her fault."

"It's not her fault, she put it onto me and I let her down. If I just went straight home from work, if I tried calling her a few more times," Derek started, running his hands through his curls.

"Derek stop, this isn't your fault." Addison told him.

"Addie's right. Amy did this to herself. I'm surprised it didn't happen sooner. You saved her life Der." Kathleen rubbed one hand down his back, the other resting on her now noticeable baby bump.

"Kath, are you?" Addison gestured to her stomach.

"Oh yeah." She pushed a lock of her dark hair behind her ear. "Four and a half months, we found out last week."

"Good for you Kathy." Mark told her, though he couldn't even force a smile on his face.

Dr. Carter emerged through the doors to the operating rooms. "She's stable, still critical but stable." He informed them and they breathed a collective sign of relief.

"Can I see her?" Derek asked.

"We're moving her to the ICU as we speak, she should be awake soon. I'll bring you there myself."

"Thank you Dr. Carter."

"I'll meet you there, I'm going to call mom and give her the news." Addison told the siblings and Mark.

The hospital felt colder than it had just a few hours before. Derek had his arm around Kathleen as they walked, her eyes blurry with tears.

"I'll leave you alone, page me if anything changes." The Doctor said as he closed the door behind them. Derek grabbed one of her hands while Mark grabbed the other, careful of the IV.

Kathy stood by her head, smoothing her matted curls away from her shallow face. "Amy you need to wake up. You've been through so much worse than this, don't give up." She whispered.

"Water?" A fourth voice croaked, snapping the attention of everyone toward her.

Mark brought a plastic cup toward her and placed the straw between her lips.

"Don't ever do that again." Derek kissed her forehead.

The icy blue eyes of the patient looked around the room. "Where am I?"

"You're at the hospital. You overdosed at Derek's house." Kathy told her.

"Oh."

"Oh? That's really all you're going to say?" Derek snapped, the lack of sleep catching up to him.

"Good to see you?" She joked, laughing then wincing. "Fuck that hurts."

"I cracked two of your ribs when I was giving you CPR." Derek muttered.

"I deserve that."

"You died Amy! You were dead and we weren't sure we could get you back." Mark pushed Derek out of the room.

"Go take a walk, take a nap, I don't care. Just get out of here before you say something you'll regret." He blocked Derek's entrance back into the room. "She's alive Shep, that's all that matters."

FIN


End file.
